The health-care of the growing child; his diet--hygiene--training --development and prevention of disease

Front matter

THE HEALTH -CARE

OF THE

GROWING CHILD

Preface

The main object of this book is to instruct and guide the intelligent mother when remote from her physician, or to advise her sufficiently in case of emergency until medical help is required and can be procured.

Our methods of feeding, hygiene, gymnastics, development, school life, and hometraining are so vastly different from what they were one decade ago that every mother who wishes to keep up to date needs must read.

So many conditions may be met with in daily routine that the average mother is likely to be bewildered and perplexed unless she has a guide near her. Every mother should know the appearance of a

[vii]

PKEFACE

healthy throat and of an inflamed throat. She should know the symptoms of adenoids and familiarize herself with rashes due to inflammatory and also to non-inflammatory conditions within the body. She should know the normal temperature and recognize fever by her thermometer.

Faulty position while sitting at home or at school, if continued, may develop spinal curvature or round shoulders. To obviate this a series of exercises is provided which show how this faulty development may be corrected. The importance of correcting this deformity early in life will be appreciated, for if it be not checked, spinal apparatus and plaster of Paris casts may ultimately be required.

Headache is frequently due to eye-strain, but there are many other causes of headache in boys and girls. These are specified in detail.

[ viii 1

PEEFACE

Sex-hygiene is so described that every mother can understand this delicate problem. What to avoid, and how to instruct boys and girls to prevent habits which may affect their future, and especially undermine their nervous system, are explained in detail.

The communicable diseases, their dangers, complications, and modern methods of quarantine are considered and presented from the modern viewpoint. Disinfection, as formerly used, is now abandoned, and modern sanitation and isolation have been described with deference to modern views.

Many illustrations showing the value of gymnastics, intended for the development of the spine, the chest, the neck, the arms, and the legs, have been added. Weak ankles and defective walking are illustrated.

The adenoid expression so frequently noted in school children has been depicted

[ix]

PKEFACE

and described. This adenoid condition should receive the close attention of every mother.

The most important illustrations show clearly how to recognize measles, chicken-pox, and smallpox. The throat is the seat of more trouble than any other part of the human body. Studies of a normal throat and of a diseased throat, showing yellowish spots on the tonsils, have been included.

Trachoma, which is regarded as one of the most treacherous of eye-diseases, and for which every medical inspector examines, is shown in such manner as to be unmistakable. In addition, the tapeworm, showing both segments and head, is included.

Enlarged glands are sometimes an early symptom of tuberculosis; this should be well remembered. Ivy poison is a frequent

[*3

PREFACE

source of irritation in school children, hence every mother should know and be able to teach her child the difference between poison-ivy and the harmless Virginia creeper.

Especial stress has been laid on the diet best suited to the growing child. Special diets, adapted to illness, have been given. Whenever possible, advice that may serve as first-aid to the injured has been given freely, and so may be said to abound throughout the book.

The Appendix will be found to contain a series of diet formulas and instructions on the application of poultices, the giving of various baths and other treatments required in caring for the sick.

The author acknowledges with pleasure the valued assistance and kindness rendered to him by his publishers, who have spared neither time nor expense to aid him

[xi]

PREFACE

in the preparation of this book, which he hopes may meet with the same cordial reception as that accorded to its predecessor, The Health-Care of the Baby.

Louis Fischer.

New York, 155 West 85th Street. September, 1915.

[xii]

Part I General Hygiene And Development Chapter Page

I. Channels of Elimination 3

II. Bathing 6

III. Ventilation 12

IV. Sleep 18

V. Exercise — Amusements 24

VI. Clothing — How to Haeden a Child .... 36

VII. School Hygiene — Summer Vacations ... 40

VIII. Characteristics and Peculiarities of

Children 47

IX. Nervous Children 55

X. Precocious Children 58

XL The Breath 60

XII. The Teeth 62

XIII. Hygiene of the Hair and Scalp 68

XIV. Growth in Height and Weight 74

XV. Puberty 75

XVI. Vaccination 84

XVII. Temperature — Fever 88

[ xiii ]

CONTENTS

Part II Nutrition Chapter Page

I. The Diet 97

Individual requirements — Milk — Quantity required — Feeding intervals — Specimen diets — Diet for a child from three to six years old — Diet for a child with weak digestion, from six to ten years old — Diet for a child over ten years of age — Diet for an underweight child — Diet for a very fat child — Diet in fever — Diet in diarrhea — Poor appetite — Vomiting.

II. Disoeders Arising From Improper Nutrition 118

The bowels — Constipation — Diarrhea — Colic or cramps — Intestinal indigestion — Rickets— Weak ankles — Scurvy.

Part III Catarrhal, Communicable, And Sys- Temic Diseases

I. Catarrhal Diseases 139

The throat — Adenoids — Tonsillitis — Rhinitis, or cold in the head — Coughs.

II. Communicable Diseases 154

How contagious diseases are spread — Table of communicable diseases — Influ- [xiv]

CONTENTS

CHAPTER PAGE

enza — Bronchitis — Bronchial asthma — Pneumonia — Tuberculosis — Whooping-cough — Mumps — Croup — True membranous or diphtheritic croup — Diphtheria — Chiekenpox — Measles — German measles — Scarlet fever — Typhoid fever.

III. Systemic Diseases 209

Appendicitis — Malaria — Rheumatism.

Part IV Diseases Of The Skin And Nekvous System

I. Diseases of the Skin 221

Rashes — Insect bites — Eczema — Erysipelas Ringworm — Ivy-poison — Sunburn — Frost-bite — Hives — Itch — Warts — Head-lice— Dandruff.

II. Diseases or the Nervous System 238

Defects of speech — Chorea — Habit spasm — Convulsions or spasms — Tuberculous meningitis — Night-terrors — Paralysis — Spinal curvature — Headache.

Part V Miscellaneous Diseases And Affections

Miscellaneous Diseases and Affections 263

Operations in children — Hernia — Enlarged glands — Fainting — Cold hands and feet —

CONTENTS

PAGE

Hiccup — Foreign bodies in the ear — Earache — Pinkeye — Sties — Trachoma — Fever-sores — Injuries — Burns — Splinters — Sprains — Bleeding — Nosebleed — Worms — Tapeworm — Bedwetting — Retention of urine — Leucorrhea — Fissure of the anus — Poisons and antidotes.

APPENDIX Food recipes, 305 — Local remedies, 313 — Ointments and lotions, 325.

Index 329

[xvi]

LIST OF ILLUSTRATIONS

Normal and Diseased Throats Frontispiece '

Ventilating Window Box Page 16

Wand Exercises, I Facing 26 "

Wand Exercises, II Facing 30 '

Pulley-weight Exercises, I Between 34 and 35^

Pulley-weight Exercises, II Between 34 and 35 '-

Pulley-weight Exercises, III Facing 36 '^

Hanging or Raising Exercise Page 34

Mat Exercises for Girls Facing 38

Small-pox Facing 84 "

Rickets Facing 132 x/

Normal Walk. Abnormal Walk Page 134

A Group of Adenoid Faces Facing 142 V-

Chicken-pox Facing 194 ^

Measles Facing 198 ^

Poison Ivy-leaf. Virginia Creeper Facing 230 v

Ivy Poisoning Facing 230 v

Spinal Curvature Facing 256 v'

Faulty Sitting Positions Between 258 and 259 V

Correct Sitting Positions Between 258 and 259 ^

Enlarged Tuberculous Glands Facing 268 *

Trachoma Facing 280

Tapeworm Facing 288

[ xvii ]

Chapter I CHANNELS OF ELIMINATION

Theke are four channels through which the body is cleansed of impurities. They are: first, the skin; second, the bowels; third, the kidneys; and fourth, the lungs.

The skin contains millions of pores The skin through which the body throws off impurities, but these impurities will only be removed if the skin is thoroughly cleansed; therefore, bathing is imperative for the healthy as well as for the sick child.

Unless one or two movements of the bow- The Bowels els takes place daily, illness will result.

Nature demands that the waste products of the system, including foul gases, be passed through the body sewer. If this sewer is clogged and obstructed the poison will remain in the system and give rise to various disturbances.

The Kidneys Next in importance in elimination are the kidneys. Every child should be reminded to empty its bladder on awakening in the morning as well as before retiring at night. The bladder should be emptied at least three to four times a day. Nature demands more frequent relief if large quantities of liquids are taken. A child should pass at least one quart of urine in twenty-four hours.

With the urine is passed excessive poisons thrown off by the blood and glands, through the kidneys. If these poisons are retained they can give rise to disease.

If the quantity of urine is scant and the child passes but an ounce or two at a time then ten drops of niter may be given in a little water, every hour for three doses. If the kidneys do not respond promptly it indicates sluggishness or perhaps congestion

CHANNELS OF ELIMINATION

of the kidneys, which must be supervised by a physician.

When fresh air is taken into the lungs The Lungs we give the body a lung tonic. The foul air passed by each expiration rids the body of poisons collected within the lungs.

Chapter II BATHING The Tepid For the healthy child a daily tub bath

Tub Bath . -

should be given in the morning, at a temperature of from 95 to 98 degrees. It is more beneficial to gradually lower the temperature of the bath two degrees daily until from 80 to 85 degrees is reached. This cooling of the water has a very toning effect on the nervous system, which is especially indicated in the nervous and restless child. In many cases it is better, immecoid shower diately after the bath, to let a shower of cold water run over the neck and shoulders for a few minutes. This will not only contract the pores and prevent the taking of cold but it is one of the best tonics for the nerve terminals.

Wlien a child is susceptible to colds and coughs, and especially if the weather is cold and damp and raw in winter, the tub bath should be given in the evening rather than in the morning. To such children the tub bath should be given first, then the supper, before retiring.

The reaction following a cold bath should Reaction be a ruddy appearance of the skin and a general glow, proving that the circulation has returned to the surface with renewed vigor. If however after the cold bath the skin does not become pink and the fingers and toes remain blue and cold it proves an incomplete reaction. The effects of such cold baths are harmful.

When after a cold bath children shiver and complain of the cold and do not feel braced up but are tired and languid, it shows that to them cold baths are depressing and harmful. We should not persist

Duration of Bath

Warm Bath with the cold baths, but instead give them tepid or warm.

A cool or cold bath for a child of from two to five years should never be given longer than two minutes, to a child of from five to ten years not longer than three minutes. Frail, sensitive, and thin children are susceptible to the influence of cold air and water, hence we should watch the body and note the color of the skin during the bath. If blueness or extreme paleness takes place, it shows that the bath should be stopped and followed by a brisk rubbing with a coarse bath towel. Exhaustion and weakness will follow in an enfeebled child if the bath is prolonged beyond the tolerance of the body. A bath properly given stimulates, a bath prolonged, depresses.

A warm bath should never be prolonged more than five to six minutes. The temperature of the water should be from 100 to 103 degrees. After briskly rubbing the skin dry, it is a good plan to rub with alcohol. This alcoholic sponging closes the pores and prevents perspiration, which otherwise might result in chilling the body.

Most children bathe too long in the surf. An ocean Bath There is no objection to giving a child an hour or several hours of activity and play on the shore, but the bath itself should never be prolonged more than ten to fifteen minutes and should then be followed by brisk rubbing. Friction after the bath to restore circulation is as important as the salt bath, and gives the reaction to the circulation.

No child of fourteen or under should be too Frequent permitted to bathe more than once a day. Too frequent bathing is harmful and lowers the vitality of the system.

The good effect of living at the seashore is frequently counteracted by too much bath-

Wading or Paddling

Bath for Sleeplessness ing, which instead of toning the system depresses the nervous system.

Wading or paddling in the sea does no harm if not carried to extreme, but it may do great harm if the heat of the sun beats upon the head while the feet and legs are in an extremely cold temperature. Frequently prolonged wading will result in intestinal catarrh and in a disturbance of the nervous system.

The warm bath at a temperature of from 103 to 105 degrees, if used from three to five minutes, with plenty of friction while in the tub, will soothe the nervous system and quiet the child. It promotes sleep.

When children are restless and their digestion is not disturbed, especially if they have been very active at school — then a very warm bath will soothe the nerves and quiet the brain, thus promoting sleep.

In order that the skin performs the function of eliminating waste material from the body it is of the utmost importance that it be kept in as perfect a condition of health as possible. The circulation must be maintained by sufficient clothing, and the waste products of the sweat glands constantly thrown out through millions of glands in the skin must be removed by frequent bathing and friction.

[ii]

Chapter III VENTILATION

The blood contains oxygen, and the coloring matter of the blood depends on its supply of oxygen; hence, pure air is a necessary factor in the nutrition of the body, and especially necessary for the building of healthy red blood corpuscles. Dangers of If therefore a child is permitted to

Foul Air

breathe foul air or air robbed of its oxygen, the result will be speedily shown by the color of the skin. Such a child, instead of having a healthy, ruddy color, has a pale, sallow color, due to the lack of oxygen. When it is remembered that an ordinary gas-jet consumes as much oxygen as five people, then we can understand why it is imperative to open windows and admit pure air if gas-jets have been burning.

VENTILATION

There are other means of polluting air in the house in addition to the burning of gas. These are: gas given off from defective stoves or furnaces, cellars that are damp, house filth, exhalations from the body, and decomposing vegetable matter.

What effect has breathing of foul air on the child ! Such a child is usually very susceptible to colds and coughs. These are the children that have a lowered vitality, and the bodily resistance being reduced they invite catarrh of the head and bronchial tubes; they also are susceptible to pneumonia and tuberculosis. After a winter of poor ventilation such children usually develop adenoid vegetations and enlarged tonsils. They are restless by day, very sensitive and nervous, and do not sleep well. As a result of the loss of sleep, the appetite is impaired. The bowels do not functionate properly. Such children are underweight

HEALTH-CAKE OF THE GEOWING CHILD

and show the evidences of malnutrition. They are subnormal, and as a result of this general weakness are more susceptible to scarlet fever and diphtheria than they would be in health.

Fresh food is to the stomach what fresh air is to the lungs. Plants absorb oxygen from the air and thrive. The same applies to the lungs, which take in the oxygen and oxygenate the blood, thus distributing healthy blood corpuscles through the vital organs of the body, also through the blood vessels which enter the skin, nerves, and the large organs of the body. The stomach, the liver, and the intestines are the vital organs of digestion, and if they carry thin blood or blood that is not up to the standard in strength, they cannot perform their proper functions and we find sluggish actions resulting therefrom. It is useless to have a child out of doors all day playing in

VENTILATION

and breathing fresh air, and then have him cooped up at night in a stuffy bedroom with windows and doors closed, and heavily blanketed. "What is gained during the day by an outdoor life is lost re-breathing foul or impure air at night. Night air is purer value of

Night Air

than day air, and the windows should remain open, with full and free ventilation, because the lungs give off poisoned air continuously.

I do not advocate placing children in draughts, but they should be given the benefit of plenty of fresh air with windows open, as thereby they will sleep better. Every mother or nurse knows that when an infant is taken into the street, especially in winter, it invariably goes to sleep, and the moment such infant is brought back into the heated house it awakens, is restless and dissatisfied until it is again taken out-of-doors.

When draughts are feared, or the wind blows too strongly, a simple contrivance consists in having a window-board inserted

OUTSIDE VIEW.

T tt T t'il'T T r T r

INSIDE VIEW.

Fig. 1.

DAYBROOK VENTILATOR WINDOW BOX.

These ventilators can be bought at department stores. A fine bronze wire screen built into the ventilator prevents dust, snow, and insects from entering. Sliding extensions make it adjustable to any window.

Ventilator Adjusted, inside view. Air is admitted from the outside, and reflected at right angles, entering the room through the top of the ventilator, where movable slides control the amount of air admitted.

after raising the window (Fig. 1). Such window-boards allow the entrance of sufficient air without causing a draught.

VENTILATION

The value of sunlight for the growth of sunlight plants is too well known to be dwelt upon. Sunlight destroys bacteria. Disease germs die when exposed to sunlight. The rays of the sun in a room occupied by a typhoid, diphtheria, or tuberculosis patient will destroy more germs and in less time than the commonly used disinfectants. It is a strong argument in favor of opening windows, admitting sunshine, and giving the bedclo thing as well as the room a sun bath.

In many sanitaria in this country and abroad patients afflicted with tuberculosis are exposed to the sun's rays. The only covering on the body is a white sheet. This is called "heliotherapy," and hardens the skin; besides, the sun's rays penetrate into the deeper parts of the lung and thereby destroy the active germ life which causes lung disease.

Chapter IV SLEEP

An active child walking or running about needs rest. During sleep the body restores its wasted energy. The nervous energy causes great destruction of the nerve-tissue, in which the brain, the muscles, and all the vital organs of the child's machine participate.

Sleep is nature 's method of repair to the vital organs. It is like an electric current which recharges the batteries of the system exhausted by the wear and tear incident to an active life.

Amount of A weak, nervous, and frail child requires

Sleep Required

more rest, and a midday rest of one-half hour after lunch. A strong and robust child

SLEEP

may do without the midday rest. Children under six years should rest at least eleven to twelve hours. A growing child should not be compared to an adult. A growing child needs proportionately more sleep. A child of from twelve to fifteen years requires from nine to ten hours' sleep. At this critical period we should insist on children retiring between 8 and 9 P.M., and rest, even if they do not sleep, until 6.30 in the morning.

When children are deprived of sleep or do not have a sound sleep their digestion will be impaired, so that loss of appetite, constipation, and indigestion may result. Irritability and restlessness by day, dulness in school, and backwardness in both physical and mental development will result from insufficient sleep.

From the loss of sleep and appetite the body will lose weight. It is surprizing to

HEALTH-CAEE OF THE GKOWING CHILD

note the bodily gain when sufficient sleep is given a child. to Promote To promote sleep the bedroom should be

Sleep r

cool and well ventilated; this will give a continuous supply of fresh air. The clothing should be loose, to permit freedom of respiration. The bedclothing should be loose and light, and the child's arms and legs free. Straight- jacket methods should be discarded.

Sufficient food should be given at the evening meal, but the stomach should not be overloaded. If too much food is given, indigestion, colic and cramps in the stomach will interfere with sleep.

No child should go to bed at night without having had a movement of the bowels during the day. If constipation exists, nature should be assisted by giving an injection of one pint of Castile soap water. (See treatment of constipation.)

SLEEP

Exciting stories which frighten the child and frequently cause dreams should not be told before retiring. Pleasant, quiet amusements and games will aid in promoting sleep.

There are many conditions which disturb sleep, causing insomnia, and if sleeplessness continues persistently a physician should be consulted.

The eating of too much candy may cause worms which will irritate the child. Indigestion, colic, earache, toothache, adenoids, or enlarged tonsils which prevent proper breathing are frequent causes of restless sleep. If a cough is present which disturbs sleep then we should suspect whooping-cough or adenoids. Masturbation in wakeful children should be suspected and watched for; this applies to girls as well as to boys. To safeguard the child where such suspicion exists we should insist on having the child sleep with its hands outside of the blankets.

The Necessity Concerning the necessity for sleep, Dr.

for Sleep

Hammond in one of his articles on l ' Sleep ' ' says: "So long as an individual is awake, there is not a single second of his life during which his brain is altogether inactive. ... Its substance is consumed by every thought, by every action of the will, by every sound that is heard, by every object that is seen, by every substance that is touched, by every odor that is smelled, by every painful or pleasurable sensation; and so each instinct of our lives witnesses the decay of some portion of its mass and the formation of a new material to take its place. . . . The necessity for sleep is due to the fact that during our waking moments the formation of the new substance does not go on as rapidly as the decay of the old. The state of comparative repose which

SLEEP

attends upon this condition allows the balance to be restored, and hence the feeling of freshness and rejuvenation we experience after a sound and healthy sleep/ '

Chapter V EXERCISE— AMUSEMENTS

Every child requires exercise. A child will run, and jump, and shout. The jumping and shouting strengthens the lungs and voice. It also develops the chest, stimulates the appetite, and aids digestion. The running stimulates the circulation of the blood, and from this active perspiration will result. Perspiration is healthful; it is the means of removing waste products through the pores of the skin. The lungs also will throw off exhalations by taking in a greater supply of oxygen. This strengthens the blood and renders the brain more active. Lung Children on awaking should be taught

Gymnastics

to take deep breaths. They should inhale and exhale very slowly. This form of lung

EXEKCISE— AMUSEMENTS

exercise will strengthen the chest-walls and if continued for weeks, months, and years will prevent flat-chested and pigeonbreasted conditions in the growing child. Breathing should be through the nose, the mouth remaining closed. If there is any obstruction in the nose and throat such as is caused by enlarged tonsils or adenoids, the same should be removed. Thorough oxygenation of the lungs is very necessary. It is nature's method of giving fresh lungfood.

All exercises and games such as ballplaying, walking, running, bar-exercise, and football have their advantages and should be encouraged. For a poorly developed chest nothing can equal rowing. This exercises not only the muscles of the arms and chest and back but also strengthens the lower limbs.

For girls the hoop, roller-skates, beanbag, skipping-rope, tennis, and rowing are among the games which may be permitted. Swimming for both boys and girls is one of the best exercises.

over Exercise No games or exercises should be permitted during the menstrual period. Children have a tendency to overtax their strength by too much exercise. Serious results may follow if the heart is overstrained, and it is the duty of every mother or nurse to be sure that the child's heart is able to stand the amount of exercise taken. While lack of exercise will render the muscles soft and flabby, so will too much exercise overstrain and cause, in some instances, irreparable damage.

proper During the period of growth the bones

are soft and yield readily, and this is the time when tight-fitting clothing will interfere with the proper expansion of the chest. Continued pressure on the chest by

Fig. 2. Position. — Wand held in both hands and resting against the front of the thighs, palms turned backward.

Fig. 3. Position. — Wand forward upward, swing, arms straight and vertical. Wand downward, swing.

Fig. 4. Position. — Step-out, right. Swing wand to right horizontal. Step-out, left. Swing wand to left horizontal. Step-out, right. Swing wand to right vertical. Step-out, left. Swing wand to left vertical.

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EXEKCISE— AMUSEMENTS

faulty clothing may result in deformity such as a flat chest. Most public schools and kindergartens give callisthenics after a short period of study and this is one of the best means of restoring the circulation of the blood after a period of brain activity. During rainy weather exercise should be given indoors.

The child should be encouraged to sleep with the windows wide open. If after studying or confinement in a room the child's hands or feet are cold, the use of pulleyweights or light dumb-bells, or a game of handball for from five to ten minutes will quickly restore the circulation of the blood.

Walking briskly is one of the best means of aiding the circulation. In modern houses the use of elevators has deprived children of one of the best means of exercise for the extremities, also for the heart, namely, stair-climbing.

HEALTH-CAEE OF THE GROWING CHILD

wand Exercise Exercise with a wand is practised in many schools. When children do not attend school this form of exercise can be carried out at home.

The wand is usually of wood, from 24 to 30 inches in length and from one-half to an inch in diameter. The ends should be rounded. These sticks can be purchased from dealers in gymnasium supplies or from furniture manufacturers. As a substitute a walking cane or the handle of a broom may be used.

This form of exercise, like dumb-bells, is especially adapted for the development of the arms. In order to properly distribute the work, these exercises, in combination with chest-, abdomen-, and leg-exercises, distribute the movements.

The inserted illustrations give an idea of the movements possible with the wand. The exercises should be continued ten to

EXERCISE— AMUSEMENTS

twenty minutes, but never to the point of fatigue. Gymnastics, twice daily from five to ten minutes, will aid in the development of the bones and muscles of the body. A graceful carriage will be acquired if the muscles have tone.

The early use of gymnastic exercises will prevent many of the deformities of the chest and spine arising from flabby, unused muscles.

Deep breathing — lung-expansion — is the best means of oxygenating the lungs. By this means we strengthen and prevent disease-germs from taking hold.

PULLEY-WEIGHT OR CHEST- WEIGHT EXERCISES

Pulley-weight exercises are adapted for the home. They are especially useful for indoor exercise during inclement weather.

These exercises should be given with one hand only, later after these simple movements are mastered both hands can be used. My preference however is for the use of the gymnasium at school or otherwise under the supervision of one competent to instruct in the development of the muscles of the body.

BEGINNER'S SERIES (WITH ONE HAND)

Right Side to Machine — I. Position — Broad base (feet straight forward, the weight on the outer borders), left hand on the hip, right, the arm out.

1st Count — Swing right arm down, poise left. (Fig. 8.)

2d Count — Bend right arm, elbow up, poise right. (Fig. 9.)

Progression — (a) 1st Count — Swing right arm down, bending trunk forward (trunk relaxed, knees straight). (Fig. 10.)

2d Count — As in I, count 2. (Fig. 9.)

Progression — (6) Position — Feet together.

1st Count — Swing the right arm down, change to left. (Fig. 11.)

2d Count — As in I, count 2. (Fig. 9.)

Fig. 5. Position.— Drop to left knee. Wand aimed forward along left arm. ^A